Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder

Attention deficit-hyperactivity disorder (ADHD) is a psychiatric and a neurobehavioral disorder. It is characterized by either significant difficulties of inattention or hyperactivity and impulsiveness or a combination of the two. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), symptoms emerge before seven years of age. There are three subtypes of the disorder which consist of it being predominantly inattentive (ADHD-PI or ADHD-I), predominately hyperactive-impulsive (ADHD-HI or ADHD-H), or the two combined (ADHD-C). Oftentimes people refer to ADHD-PI as "Attention deficit disorder" (ADD), however, the term was revised in the 1994 version of the DSM.

ADHD impacts school-aged children and results in restlessness, acting impulsively, and lack of focus which impairs their ability to learn properly. It is the most commonly studied and diagnosed psychiatric disorder in children, affecting about 3 to 5 percent of children globally and diagnosed in about 2 to 16 percent of school-aged children. It is a chronic disorder with 30 to 50 percent of those individuals diagnosed in childhood continuing to have symptoms into adulthood. Adolescents and adults with ADHD tend to develop coping mechanisms to compensate for some or all of their impairments. It is estimated that 4.7 percent of American adults live with ADHD. Standardized rating scales such as the World Health Organization's Adult ADHD Self-Report Scale can be used for ADHD screening and assessment of the disorder's symptoms' severity.

ADHD is diagnosed two to four times more frequently in boys than in girls, though studies suggest this discrepancy may be partially due to subjective bias of referring teachers. ADHD management usually involves some combination of medications, applied behavior analysis (ABA, previously known as behavior modification), lifestyle changes, and counseling. Its symptoms can be difficult to differentiate from other disorders, increasing the likelihood that the diagnosis of ADHD will be missed. In addition, most clinicians have not received formal training in the assessment and treatment of ADHD, in particular in adult patients.

ADHD and its diagnosis and treatment have been considered controversial since the 1970s. The controversies have involved clinicians, teachers, policymakers, parents and the media. Topics include ADHD's causes, and the use of stimulant medications in its treatment. Most healthcare providers accept that ADHD is a genuine disorder with debate in the scientific community centering mainly around how it is diagnosed and treated. The National Institute for Clinical Excellence in 2004, while acknowledging controversies and criticisms, stated that the current therapeutic treatment interventions and methods of diagnosis for ADHD are based on the dominant view of the academic literature. NICE further concluded that despite such criticism, ADHD represented a valid clinical condition, with genetic, environmental, neurobiological, and demographic factors. According to NICE, only children with severe ADHD symptoms should be considered for medication as a first-line treatment option. Medication therapy can also be considered for those with moderate ADHD symptoms who either refuse psychotherapeutic options or else fail to respond to psychotherapeutic input.